The efficacy of intravenous lidocaine and its side effects in comparison with intravenous morphine sulfate in patients admitted to the ED with right upper abdominal pain suspected of biliary colic
Intravenous (IV) Lidocaine can be used as analgesic in acute pain management in the emergency department (ED). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 9, 2020 Category: Emergency Medicine Authors: Atousa Akhgar, Tayebe Pouryousefi, Amir Nejati, Hosein Rafiemanesh, Hooman Hossein-nejad Source Type: research

Transient amnesia with delayed recovery following prehospital low-dose ketamine analgesia
Low doses of ketamine have been shown to be safe and effective for pain relief. Adverse effects are generally mild and transient. A 69-year-old woman suffered a witnessed ground-level fall without report of head injury, loss of consciousness, or intoxication. She was in severe pain despite 10  mg of intravenous morphine and paramedics provided intravenous ketamine 16 mg (0.19 mg/kg). Upon arrival to the ED, she was alert and oriented. An X-ray demonstrated an acute comminuted nondisplaced right humeral head and neck fracture. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 9, 2020 Category: Emergency Medicine Authors: Raniah Aljadeed, Stephen Perona Source Type: research

COVID-19 pneumonia with hemoptysis: Acute segmental pulmonary emboli associated with novel coronavirus infection
Recent retrospective studies from Wuhan, China suggest Novel Coronavirus Disease 2019 (COVID-19) may be associated with a hypercoagulable state and increased risk for venous thromboembolism. The overlap in the signs and symptoms of COVID-19 associated Acute Respiratory Distress Syndrome (ARDS) and COVID-19 with concurrent pulmonary embolism creates a diagnostic challenge for emergency medicine physicians in patients already at risk for renal impairment. However, identifying features atypical for COVID-19 alone may play a role in the judicious use of Computed Tomography Angiography among these patients. (Source: The America...
Source: The American Journal of Emergency Medicine - April 8, 2020 Category: Emergency Medicine Authors: Kyla Casey, Alexander Iteen, Reese Nicolini, Jonathan Auten Source Type: research

Patients accept screening for mental health and substance use disorders while ED clinicians support only if able to refer
Mental health and substance use disorder (MHSUD) visits to the emergency department (ED) are frequent and increasing [1-5]. The ED is often the first contact for patients with MHSUD [6], and provides an opportunity for screening, brief intervention, and referral to treatment [7]. Universal screening for MHSUD in the ED has proven controversial. The American College of Emergency Physicians (ACEP) has argued that MHSUD screening, particularly for suicidal ideation, should only occur if there are sufficient resources for screening and outpatient referrals [8]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 8, 2020 Category: Emergency Medicine Authors: Sacha A. McBain, Eva Woodward, Brooke E. Palmer, Sara J. Landes, Michael P. Wilson Source Type: research

Comparative evaluation of the clinical safety and efficiency of supraclavicular and infraclavicular approaches for subclavian venous catheterization in adults: A meta-analysis
In this meta-analysis, we investigated the success rate of subclavian venous catheterization (SVC) as well as the incidence of related complications when performed via the supraclavicular (SC) or traditional infraclavicular (IC) approaches. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 8, 2020 Category: Emergency Medicine Authors: Qi Chen, Qin Long, Jing-qiu Liang, Tan-xiao Tang, Bin Yang Source Type: research

Chest CT in patients suspected of COVID-19 infection: A reliable alternative for RT-PCR
With the increasing prevalence of coronavirus disease-19 (COVID-19) infection worldwide, early detection has become crucial to ensure rapid prevention and timely treatment. However, due to the unknown gene sequence of the supposed coronavirus, the reference standard test has not been established for diagnosis [1]. Several methods have been established for prompt detection of the genetic sequence of COVID-19 nucleic acid such as real-time reverse-transcriptase polymerase chain reaction (RT-PCR). However, this test is not readily available everywhere, especially in developing countries. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 8, 2020 Category: Emergency Medicine Authors: Hadi Majidi Source Type: research

Validation of a decision rule to predict patients at low risk of variceal upper gastrointestinal hemorrhage
Determining the likelihood of a variceal versus nonvariceal source of upper gastrointestinal bleeding (UGIB) guides ED therapy, but can be difficult to determine on clinical grounds. A simple decision rule, using only platelet and international normalized ratio (INR) values, was previously derived in a single center and had high sensitivity (97%). We sought to validate this decision rule using multi-center data. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 7, 2020 Category: Emergency Medicine Authors: Brian E. Driver, Gabriella Horton, Alan Barkun, Myriam Martel, Lauren R. Klein Source Type: research

Spectrum and frequency of critical procedures performed at a Level I adult and pediatric trauma center
The primary objective of this study was to provide physician-level data about the frequency of critical procedures at a combined adult and pediatric Level I trauma center, high-acuity, high-volume academic ED. The inspiration for this study question came from a previous study by Mittiga et al. (2013) describing pediatric critical procedure data at a similar high-acuity, high-volume, pediatric-only academic ED. Our secondary objective is to compare our pediatric level procedural spectrum and frequency with those published by Mittiga et al. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 7, 2020 Category: Emergency Medicine Authors: Rebecca L. Kornas, Stephen W. Smith, Erik Fagerstrom, Audrey Hendrickson, Jean Tersteeg, David Plummer, Brian E. Driver, Ashley M. Strobel Source Type: research

The effective use of telemedicine to save lives and maintain structure in a healthcare system: Current response to COVID-1
Throughout the response to the COVID19 crisis, many healthcare institutions have increased their use of telecommunications. From medical schools to residency programs, from patient interactions at home to those in quarantine, virtual communication is providing a safe way to continue with our responsibilities during this pandemic. According to POTUS (17 March 2020), telemedicine, with lessened HIPAA regulations, is now an approved method of communication between physicians and patients for those with Medicare [1]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 7, 2020 Category: Emergency Medicine Authors: Adel Elkbuli, Haley Ehrlich, Mark McKenney Source Type: research

Diagnosis of neurofibromatosis type 1 after rupture of aneurysm and consequent fatal hemothorax
Patients with neurofibromatosis type 1 (NF1) can develop both benign and malignant tumors throughout their lives. A 49-year-old man was transferred to the emergency department with complaints of sudden right dorsal pain and respiratory discomfort. He was in shock on arrival. On finding significantly decreased permeability of the left lung field in chest X-ray, drainage was immediately performed. Subsequent computed tomography (CT; Lammert et al., 2005) angiography revealed the extravasation of contrast media from the deep carotid artery, a branch of subclavian artery. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 7, 2020 Category: Emergency Medicine Authors: Kazuyuki Miyamoto, Motoyasu Nakamura, Keisuke Suzuki, Shino Katsuki, Yuki Kaki, Gen Inoue, Takanori Ohno, Jun Sasaki, Kenji Dohi, Munetaka Hayashi Source Type: research

Trends in Adult Patients Presenting to Pediatric Emergency Departments
Adults presenting to pediatric emergency departments (PEDs) include those with complex chronic conditions (CCCs) often still followed by pediatric providers, and those without CCCs (non-CCCs). This paper describes recent trends in adults seen within PEDs, both by age subgroups and CCC status. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 7, 2020 Category: Emergency Medicine Authors: Cherisse Mecham, Lucia Mirea, Ryan Bode, Jon McGreevy Source Type: research

Serum total carbon dioxide as a prognostic factor for 28-day mortality in patients with sepsis
This study was performed to investigate the association between serum total carbon dioxide (TCO2) concentration and 28-day mortality in patients with sepsis. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 7, 2020 Category: Emergency Medicine Authors: Jin Hee Kim, Dong-Hyun Jang, You Hwan Jo, Gil Joon Suh, Woon Yong Kwon, Jae Hyuk Lee, Jonghwan Shin, Inwon Park, Che Uk Lee, Sang-Min Lee Source Type: research

The standardized method and clinical experience may improve the reliability of visually assessed capillary refill time
Reliability of capillary refill time (CRT) has been questionable. The purpose of this study was to examine that a standardized method and clinical experience would improve the reliability of CRT. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 7, 2020 Category: Emergency Medicine Authors: Koichiro Shinozaki, Lee S. Jacobson, Kota Saeki, Naoki Kobayashi, Steve Weisner, Julianne M. Falotico, Timmy Li, Junhwan Kim, Joshua W. Lampe, Lance B. Becker Source Type: research

Intrathecal bupivacaine and morphine toxicity leading to transient hypotension and delayed status epilepticus
We appreciate the thoughtful and constructive feedback submitted. We certainly acknowledge the potential contribution of morphine to the clinical presentation of our patient [1-4], but the responsibility of any one drug to the presentation is largely unknowable without data on the toxicity of intrathecal bupivacaine. Excessive CNS delivery of each drug could logically be anticipated to cause deleterious effects. It would be overly dismissive to exclude bupivacaine's potential contribution. First, bupivacaine was administered in an overdose of equal proportion relative to its therapeutic spinal dose as morphine. (Source: Th...
Source: The American Journal of Emergency Medicine - April 6, 2020 Category: Emergency Medicine Authors: Alexander M. Sidlak, Joseph H. Yanta, Michael J. Lynch Source Type: research

Hypotension and status epilepticus in relation to intrathecal morphine administration
Editor - We were very interested to read the recent case report by Sidlak et al. [1] describing signs of central nervous system (CNS) toxicity following intrathecal pump refill with morphine and bupivacaine. The patient developed “sensory neuropathy” and flaccid paralysis of the lower extremities, hypotension, altered mental status and status epilepticus. The authors ascribed most of these symptoms to bupivacaine “neurotoxicity” and the failure of lipid emulsion infusion to resolve the seizures to “poor CNS penetra tion”. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 3, 2020 Category: Emergency Medicine Authors: Bruno M égarbane, Guy L. Weinberg Source Type: research

Inhaler intoxications developed during autopsy of the corpse due to cyanide intake: Case series
The primary cause of cyanide intake is suicidal attempts, most of which result in death. People who interfere with suspicion of cyanide intoxication may also be exposed to cyanide poisoning.During the autopsy of the corpse in the morning of that day, five people in the autopsy room within the hospital were admitted to the ED with suspicion of cyanide intoxication. Meanwhile, a 36-year-old patient who had come into contact with the patient at night also presented to the ED. Some of the precautionary measures to be taken against inhalation of cyanide may be wearing appropriate masks as well as suitable clothes and keeping th...
Source: The American Journal of Emergency Medicine - April 2, 2020 Category: Emergency Medicine Authors: Murat Seyit, Atakan Yilmaz, Mert Ozen, Cansu Dogan, Ahmet Ali Kantar Source Type: research

Comparing the analgesic effect of intravenous paracetamol with morphine on patients with renal colic pain: A meta-analysis of randomized controlled studies
The choice of intravenous paracetamol or morphine for the pain control of renal colic remains controversial. We conduct a systematic review and meta-analysis to compare the analgesic efficacy and safety of intravenous paracetamol with morphine for renal colic pain. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 2, 2020 Category: Emergency Medicine Authors: Jian Ma, Yanhong Zhao, Huihui Fan, Jia Liu Source Type: research

High-dose nitroglycerin infusion for the management of sympathetic crashing acute pulmonary edema (SCAPE): A case series
Sympathetic crashing acute pulmonary edema (SCAPE) describes the most severe presentation of acute heart failure (AHF). Immediate intervention is required to prevent hemodynamic decompensation and endotracheal intubation. Although high-dose nitroglycerin (>100  μg/min) has been described for this clinical scenario in limited case reports, the concern for adverse effects such as hypotension and syncope limit providers comfortability in initiating nitroglycerin at these doses. Described here is a case series of four patients who safely and effectively re ceived high-dose nitroglycerin infusions for the management of ...
Source: The American Journal of Emergency Medicine - April 2, 2020 Category: Emergency Medicine Authors: Krisi Stemple, Kyle M. DeWitt, Blake A. Porter, Michael Sheeser, Eike Blohm, Mark Bisanzo Source Type: research

Social distancing during the COVID-19 pandemic: Staying home save lives
The severity of the COVID-19 outbreak is the greatest public health threat caused by a respiratory virus since 1918. According to the Imperial College, 2.2 million Americans could die if we do not mitigate the spread of infection [1]. With the incidence of COVID-19 increasing, it may only be time before the healthcare system becomes overwhelmed and forces physicians to triage treatment among critically ill patients. Without an intervention, it is likely that there will be more seriously ill people than we have the resources to care for [1]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 2, 2020 Category: Emergency Medicine Authors: Brendon Sen-Crowe, Mark McKenney, Adel Elkbuli Source Type: research

Rare case of severe rhabdomyolysis secondary to human granulocytic anaplasmosis
Anaplasma phagocytophilum (AP) is the causative agent of human granulocytic anaplasmosis (HGA), a tick-borne illness with highest incidence in north-eastern regions of the United States. This condition presents with vague constitutional symptoms and has been associated with laboratory derangements such as leukopenia, thrombocytopenia and transaminitis [1]. Rhabdomyolysis, however, is not one of these associations. There has only been one prior case report in which a patient developed rhabdomyolysis-induced acute kidney injury (AKI) secondary to AP, that too in the setting of concomitant statin use [2]. (Source: The America...
Source: The American Journal of Emergency Medicine - April 2, 2020 Category: Emergency Medicine Authors: Jasanjeet Jawanda Source Type: research

Editorial Board
(Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 1, 2020 Category: Emergency Medicine Source Type: research

Toc
(Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 1, 2020 Category: Emergency Medicine Source Type: research

Info for authors
(Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 1, 2020 Category: Emergency Medicine Source Type: research

The representation of women and underrepresented minorities in emergency medicine: A look into resident diversity
Although emergency medicine physicians serve a diverse population, the representation of women and underrepresented minorities in the workforce lags behind. The sex, racial, and ethnic composition of emergency medicine trainees does not reflect the diverse populations they serve. According to the Association of American Medical Colleges, underrepresented in medicine (URM) means “those racial and ethnic populations that are underrepresented in the medical profession relative to their numbers in the general population.” [1] Women make up over 50% of the U.S. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 1, 2020 Category: Emergency Medicine Authors: Benjamin Partiali, Sandra Oska, Antonio Barbat, Adam Folbe Source Type: research

The effect of hemodialysis on N-terminal pro-brain natriuretic peptide: A systematic review and meta-analysis
N-terminal pro-brain natriuretic peptide (NT-pro BNP) increases in patients with heart failure and renal failure. Hemodialysis is a useful treatment to these patients. The aim of this study was to conduct a systematic and meta-analysis to evaluate the influence of hemodialysis on NT-pro BNP concentration. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 1, 2020 Category: Emergency Medicine Authors: Lei Yin, Zhenzhen Han, Qing Zhang, Jiada Xie, Chunpeng Wang, Lianxing Zhao Source Type: research

Strategic planning and recommendations for healthcare workers during the COVID-19 pandemic
During this pandemic it is imperative to wisely allocate our healthcare workforce and resources. A strategic plan for our healthcare system must both utilize and conserve resources from other medical specialties, including surgery. Surgical teams can play an unexpectedly large role in this global crisis. On 22 March 2020, POTUS guaranteed increased output for highly demanded resources, though the delivery date of these items remains unknown [1]. Similarly, it is not a simple task to replenish our healthcare workforce. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 1, 2020 Category: Emergency Medicine Authors: Haley Ehrlich, Mark McKenney, Adel Elkbuli Source Type: research

Ramped versus sniffing position for tracheal intubation: A systematic review and meta-analysis
This study aimed to determine the efficacy and safety of tracheal intubation in the ramped versus sniffing position. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 1, 2020 Category: Emergency Medicine Authors: Yohei Okada, Yujiro Nakayama, Katsuhiko Hashimoto, Kaoru Koike, Norio Watanabe Source Type: research

Levosimendan with other inotropes or vasopressors: Should you combine them?
Levosimendan is used in selected patients with acute Heart Failure (AHF). However, it is not suitable to treat those with hypotension [systolic blood pressure (SBP) (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - April 1, 2020 Category: Emergency Medicine Authors: Gon çalo J.L. Cunha, Bruno M.L. Rocha, Rita V. Gomes, Mário Ferraz, Lúcia Fernandes, Rui Morais, Luís Campos, Inês Araújo, Cândida Fonseca Source Type: research

Topiramate: A novel protective agent against ischemia reperfusion-induced oxidative injury after testicular torsion/detorsion
Testicular torsion is a common urologic emergency and one of the causes of genital injury in males. Hence, early diagnosis and treatment are necessary to prevent testicular damage and infertility. It has been proved that topiramate (TPM) a medication used to treat epilepsy and prevent migraines has anti-inflammatory and anti-oxidative effects. Therefore, this study was designed to determine the influence of TPM on ischemia/reperfusion injury following testicular torsion/detorsion (T/D). Thirty-six male Wistar rats were divided into three groups (n  = 12 for each group) including sham operated, T/D + vehicle, T/D ...
Source: The American Journal of Emergency Medicine - April 1, 2020 Category: Emergency Medicine Authors: Abbas Jafari, Hojat Ghasemnejad-Berenji, Mohadeseh Nemati, Morteza Ghasemnejad-Berenji Source Type: research

High-dose adenosine for treatment of refractory paroxysmal supraventricular tachycardia
Paroxysmal supraventricular tachycardia (PSVT) is one of the more common arrhythmias requiring treatment in the emergency department. Intravenous adenosine is recommended as the initial medication of choice for treatment of PSVT, given in escalating doses up to a maximum of 12  mg. With a serum half-life of less than 10 s, adenosine must be given rapidly to allow for adequate time for it to reach the heart via venous return. In over 10% of adult patients, PSVT will not be terminated with maximum doses of adenosine. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 31, 2020 Category: Emergency Medicine Authors: Lily Cheng, Wesley Eilbert Source Type: research

Abdominal and testicular pain: An atypical presentation of COVID-19
The outbreak of a novel coronavirus disease (COVID-19) has led to the current global health crisis. As of late March, there have been over 315,000 cases worldwide and over 25,000 cases in the United States [1]. COVID-19 has been of concern to many health care workers (HCW's) in the emergency department (ED), due to potential exposure and the possibility of transmitting the virus to other patients and family members. Currently, personal protection equipment (PPE) recommendations are in flux and it is unclear if patients outside of “flu-like symptoms” require PPE [2]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 31, 2020 Category: Emergency Medicine Authors: Jesi Kim, Todd Thomsen, Naomi Sell, Andrew J. Goldsmith Source Type: research

Are loose-fitting powered air-purifying respirators safe during chest compression? A simulation study
The application of appropriate personal protective equipment for respiratory protection to health care workers is a cornerstone for providing safe healthcare in emergency departments. We investigated the protective effect and usefulness of loose-fitting powered air-purifying respirators (PAPRs) during chest compression. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 31, 2020 Category: Emergency Medicine Authors: Soo Hyun Park, Sung Yeon Hwang, Guntak Lee, Jong Eun Park, Taerim Kim, Tae Gun Shin, Min Seob Sim, Ik Joon Jo, Seonwoo Kim, Hee Yoon Source Type: research

The effects of ceftriaxone by intravenous push on adverse drug reactions in the emergency department
We examined if this change led to an increase in adverse reactions. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 30, 2020 Category: Emergency Medicine Authors: Abdulkareem Agunbiade, Joanne C. Routsolias, Lum Rizvanolli, Will Bleifuss, Sharadram Sundaresan, Jordan Moskoff Source Type: research

Comparing neighborhood-based indices of socioeconomic risk factors and potentially preventable emergency department utilization
Neighborhood stress score (NSS) and area deprivation index (ADI) are two neighborhood-based composite measures used to quantify an individual's socioeconomic risk based on home location. In this analysis, we compare the relationships between an individual's socioeconomic risk, based on each of these measures, and potentially preventable acute care utilization. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 26, 2020 Category: Emergency Medicine Authors: Lucas C. Carlson, Jungyeon Kim, Margaret E. Samuels-Kalow, Brian J. Yun, Dellara F. Terry, Jeffrey B. Weilburg, Jarone Lee Source Type: research

Complications in the adult asplenic patient: A review for the emergency clinician
The spleen performs several important physiologic functions. However, patients can have functional asplenia or have their spleen removed for a number of reasons, which can put them at risk for several dangerous complications. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 26, 2020 Category: Emergency Medicine Authors: Brit Long, Alex Koyfman, Michael Gottlieb Source Type: research

Clinician experience of nudges to increase ED OUD treatment
Data from the last decade has demonstrated that the national rate of emergency department (ED) presentations for opioid-related issues has increased by nearly 100% [1]. Accordingly, EDs have begun to increase their capacity to treat opioid use disorder (OUD) in an evidence based manner [2]. Extensive research demonstrates that using medication for addiction treatment (MAT) with buprenorphine to treat OUD effectively increases retention in treatment, reduces illicit opioid use, and decreases all-cause and opioid-related mortality [3-6]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 26, 2020 Category: Emergency Medicine Authors: Alister Martin, Josh Baugh, Tyler Chavez, Jess Leifer, Lee-Sien Kao, Sayon Dutta, Ben White, Bryan Hayes, Dawn Williamson, Ali Raja Source Type: research

Critical pancreatitis management associated with hypertriglyceridemia in pregnancy in emergency service
The author responds: (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 25, 2020 Category: Emergency Medicine Authors: Dilay Sat ılmış, Ömer Faruk Türkoğlu, Ramazan Güven, Başar Cander Source Type: research

Reply to Bhakta et al.: “Mortality benefit shock index in prehospital level care: Our reply to Jouffroy R et al.?”
Dear Editor, (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 25, 2020 Category: Emergency Medicine Authors: Romain Jouffroy, Jean Pierre Tourtier, Papa Gueye, Emmanuel Bloch-Laine, Vincent Bounes, Guillaume Debaty, Josiane Boularan, Beno ît Vivien Source Type: research

A new method of hiccup therapy in the emergency department: Intradermal injection
Hiccup is a condition caused by involuntary contraction of inspiratory muscles, especially the diaphragm. Although it is generally considered as a physiological.response, if hiccup persists for a long time, it can lead to many undesirable conditions such as depression, weight loss, insomnia, and fatigue. A 35-year-old male patient was admitted to our emergency department with hiccup lasting for 15  h. He had a history of several hiccup attacks. Classical non-pharmacological and pharmacological therapies were used to treat the condition without any response. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 25, 2020 Category: Emergency Medicine Authors: Abdullah Osman Kocak, Ilker Akbas, Meryem Betos Kocak, Sultan Tuna Akgol Gur, Zeynep Cakir Source Type: research

Novel complication of ozone therapy: Massive emphysema and pneumomediastinum
In recent years, patients who do not benefit from current medical treatments resort to alternative medicine methods. Although the effectiveness of these methods is controversial, the number of patients applying for these methods is increasing day by day. From the perspective of physicians, the search for different treatment methods has existed since the first years of the art of medicine. For this reason, treatment methods for different diseases have been continuously experienced. Some treatment methods were successful, while others were found to be useless or harmful to patients. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 25, 2020 Category: Emergency Medicine Authors: Bu ğra Ilhan, Halil Doğan Source Type: research

Is traditional Chinese medicine useful in the treatment of COVID-19?
Recently, there were lots of debate going throughout the world regarding the current outbreak and treatment of coronavirus disease 2019 (COVID-19). As a traditional Chinese medicine (TCM) practitioner, I believe that the TCM treatment of COVID-19 was ignored. On Feb 6, 2020, guideline for rapid advice on diagnosis and treatment of 2019-ncov pneumonia have been released in China [1]. For the treatment of COVID-19, the guideline recommended using routine treatment plus TCM in the field. Routine treatment comprises use of antiviral therapy and antibiotics, nutritional support, mechanical ventilation when necessary and so on. ...
Source: The American Journal of Emergency Medicine - March 25, 2020 Category: Emergency Medicine Authors: Kai Zhang Source Type: research

Toluidine blue
We read the correspondence entitled “The forensic rape examination: Is colposcopy really necessary?” with interest [1]. Sexual assaults are an important medical and legal problem that concerns many disciplines [2]. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 25, 2020 Category: Emergency Medicine Authors: Alper Keten, Erdem Okdemir Source Type: research

Prehospital Shock Precautions on Triage (PSPoT) score to assess in-hospital mortality for septic shock
We report the association between The Prehospital Shock Precautions on Triage (PSPoT) score, and in-hospital mortality of SS patients initially cared for in th e prehospital setting by a mobile ICU (MICU). (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 25, 2020 Category: Emergency Medicine Authors: Romain Jouffroy, Jean Pierre Tourtier, Pascal Philippe, Emmanuel Bloch-Laine, Vincent Bounes, Papa Gueye-Ngalgou, Benoit Vivien Source Type: research

The rule of two's didn't work: Meckel's diverticulum with hemorrhagic shock in an adolescent
We report the case of a 13-ye ar-old male presenting in hemorrhagic shock secondary to an undifferentiated gastrointestinal bleed who was effectively resuscitated in a children's emergency department. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 24, 2020 Category: Emergency Medicine Authors: Hillary Spangler, Joseph Fisher Tags: Case Report Source Type: research

Mortality benefit of shock index in prehospital level care: Our reply to Jouffroy R et al.
We are really thankful to Jouffroy R et al. for re-evaluating impact of shock index (SI) guided management of septic shock in pre-hospital setting, the good age old yet simple tool, to assess the mortality outcome in at 28  days [1]. Higher score of SI is known to predict worse outcome [2], which this study also re-established. While we accept the fundamental conclusion that higher SI is associated with increased mortality in sepsis patients in pre-hospital setups; we feel that the result needs introspection and furt her validation. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 24, 2020 Category: Emergency Medicine Authors: Pradipta Bhakta, Habib Md Reazaul Karim, Mohanchandra Mandal, Michele Claudio Vassallo Source Type: research

The rule of two's didn't work: a case of Meckel's diverticulum with hemorrhagic shock in an adolescent
We report the case of a 13- year-old male presenting in hemorrhagic shock secondary to an undifferentiated gastrointestinal bleed who was effectively resuscitated in a children's emergency department. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 24, 2020 Category: Emergency Medicine Authors: Hillary Spangler, Joseph Fisher Source Type: research

Coronavirus Disease (COVID-19): A primer for emergency physicians
Rapid worldwide spread of Coronavirus Disease 2019 (COVID-19) has resulted in a global pandemic. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 24, 2020 Category: Emergency Medicine Authors: Summer Chavez, Brit Long, Alex Koyfman, Stephen Y. Liang Source Type: research

COVID 19 a challenge for emergency medicine and every health care professional
To the Editor, (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 24, 2020 Category: Emergency Medicine Authors: Jacek Smereka, Lukasz Szarpak Tags: Correspondence Source Type: research

Relationship between the number of pediatric patients with rotavirus and telephone triage for associated symptoms
Earlier syndromic surveillance may be effective in preventing the spread of infectious disease. However, there has been no research on syndromic surveillance for rotavirus. The study aimed to assess the relationship between the incidence of rotavirus infections and the number of telephone triages for associated symptoms in pediatric patients under 4  years old in Osaka prefecture, Japan. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 24, 2020 Category: Emergency Medicine Authors: Yusuke Katayama, Kosuke Kiyohara, Sho Komukai, Tetsuhisa Kitamura, Kenichiro Ishida, Tomoya Hirose, Tasuku Matsuyama, Takeyuki Kiguchi, Takeshi Shimazu Source Type: research

Association of body mass index and clinical complications of patients with ST-elevation myocardial infarction
We read the article written by McDonald et al. with great interest and appreciation [1]. Their study showed that young patients with ST-elevation myocardial infarction (STEMI) with low body mass index (BMI) or females with a high BMI appeared to have higher risks for complications and/or death. However, the results of the study should be interpreted in consideration of some aspects as described below. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - March 24, 2020 Category: Emergency Medicine Authors: Jianxun Zhao, Rongsheng Du, Xun Ran, Zhi Zeng Source Type: research